Analyzing the implications of Ghana’s increased testing of COVID-19

Increased and widespread testing has been identified as one of the keys to containing the spread of Covid19 and flatten the growth rate of positive cases in a nation. If you’ve been watching CNN lately, you will hear Dr Fauci of the US stress this point whenever he gets the chance.

However, this approach comes with a short term problem that governments would ideally want to avoid; an initial increase or spike in the number of positive cases. This is a source of concern because governments would want to manage fear amongst its citizens, and these initial spikes in positive cases are likely to drive apprehension and fear.

That said, it’s been proven beyond a reasonable doubt that the more you test to identify hidden carriers of the virus and quarantine them early to ensure that they don’t spread the disease, the higher a country’s chances of flattening the curve in the medium term. Unfortunately, the daily COVID data that are presented to the public often exclude this highly informative data; RATIO OF POSITIVE CASES TO NUMBER OF TESTS.

This ratio is more informative than the absolute number of cases that are presented on a daily basis. For example, as South Africa’s number of positive cases surged and surpassed that of Nigeria, Ghana and other sub-Saharan African (SSA) countries, all that the absolute numbers suggested to us were that South Africa was potentially going to be the epicenter of Covid19 of the sub-region should Africa lose the fight to contain the highly contagious disease. However, much information wasn’t provided to help us answer the more insightful question;

“Why the surge in positive cases in South Africa compared to other African countries?”

The data provided by worldometer https://www.worldometers.info/coronavirus/ gives us such insights! It is clear that South Africa’s and Ghana’s increased number of testing is the main reason behind the surge in their number of positive cases relative to other African countries. These results, when put in proper perspective, should be more comforting for Ghana and South Africa compared to countries with significantly less testing and therefore lower positive cases. I present a few Ratios of Positive Cases to Number of Tests for selected SSA countries as of yesterday:

Ghana was 566/37,954 = 1.49%

South Africa was 2,173/80,085 = 2.71%

Nigeria was 323/5,000 = 6.46%

Kenya was 197/7,449 = 2.64%

Togo was 76/2,532 = 3.0%

Some North African Countries’ ratios:

Egypt was 2,065/25,000 = 8.26%

Morocco was 1,661/8,473 = 19.6%

Algeria was 1,914/3,359 = 56.98%

Clearly, from the 8 selected countries above, although Ghana has the 5th largest absolute number of positive COVID cases (566), it has the lowest rate of incidence, just 1.49%, when comparing the number of positive cases to the number of tests. Nigeria has a lower number of identified positive cases, 323, but with its low number of tests, 5,000, its positive incidence rate is significantly higher at 6.46%.

This suggests that it’s likely that should Nigeria test as many as Ghana or South Africa, its number of positive cases are likely to surpass these two countries. This is highly instructive, because a priori, we would expect that the more we test, the more positive cases you will identify to enable you to quarantine them and help contain the spread!

South Korea is an example of a country that focused on increased testing to curb the spread of the disease and flatten its curve of the growth rate in positive cases!

See https://www.weforum.org/agenda/2020/03/south-korea-covid-19-containment-testing/.

The President of Ghana, Nana Akufo-Addo during his last address on Covid19 to the nation stressed on the importance of the past week as results of the increased testing of those being contact traced came in. At least we now have a better picture of what we are dealing with and can quickly quarantine these new cases to curb the spread, rather than live in a world of ignorance with low number of positive cases whiles these hidden cases spread the disease.

Basic empirical research techniques will tell us that the larger the sample size, the more representative the results are compared to that of the population, other factors remaining the same! So the more tests, the better the results are in representing the reality or the more it gives us a true picture!

As such, I commend the Government for choosing to take the highly bold South Korea approach that has been proven to be more successful even though in the short term the spike in positive results are likely to lead to some increased anxiety and even fear.

But we should all be reminded that the fight against Covid19 is not a sprint, but rather a marathon! So in addition to the excellent increased testing strategy being adopted by the Government of Ghana, let us all play our part in adhering to all appropriate personal hygiene and social distancing measures!.

#PragmaticSolutions

#PreachCalmOverFear

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